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Prostate cancer - your questions answered

Meet our experts

For this topic, Cancer Care Operations Manager, Nurse Evelyn Wallace, and her team of Dedicated Cancer Nurses at AXA PPP, answer your questions about coping with prostate cancer.

Here we’ve rounded up the best of the team’s support and insights around the most commonly asked questions:

What is prostate cancer?

The prostate is a small gland in a man’s pelvis below the bladder, which produces the fluid that mixes with sperm to create semen.

Prostate cancer is the most common cancer affecting men in the UK. It tends to develop quite slowly and people can live for a long time without symptoms or needing treatment.

Prostate cancer is more common in men over 50 and is very rarely seen in men under 40. But if a first degree relative, such as father or brother, has prostate cancer aged 60 years old or younger, this puts you at increased risk.

The younger you are at diagnosis, the more aggressive the cancer – and therefore the treatment – is likely to be.

What are the symptoms of prostate cancer?

There are often no signs or symptoms of prostate cancer and those that exist may be very subtle and hard to detect. They include the following:

Needing to urinate urgently

Difficulty in urinating (if the flow stops, starts or you have to strain to urinate)

Some of the symptoms of prostate cancer can be caused by benign conditions, so there may be nothing to worry about. Currently there are no set screening programmes in the UK for prostate cancer, therefore, should you have any concerns please contact your GP.

How do you test for prostate cancer?

The NHS does not offer a screening programme for prostate cancer in the UK because it has not been proved that the benefits would outweigh the risks.

The most common test for prostate cancer is a PSA test. This is a blood test that measures Prostate Specific Antigen – a protein which increases with prostate cancer.

But PSA tests aren't particularly reliable – and aren’t reliable enough to serve as screening tests. PSA levels can rise for lots of reasons other than prostate cancer – such as urine/prostate infections, after any surgery to the prostate, as you get older or in non-cancerous enlargement of the prostate.

Other tests include a physical examination, a digital rectal examination (DRE) or a biopsy.

Can you prevent prostate cancer?

Research has suggested that certain foods can reduce your risk, though they don't currently understand fully why.

Foods that are thought to reduce the risk include soy, vegetables such as spinach, broccoli and kale, green tea and pulses.

Foods which may increase risk are processed meats, and a high intake of dairy products and foods high in saturated fat.

As with any medical condition, and in particular cancer, your best course of action is to keep a healthy diet and lifestyle. A diet rich in vegetables and fruit – and low in saturated fats – is your best way forward. Exercise is recommended, as is cutting back on bad habits like sweets, alcohol and cigarettes.

How is prostate cancer treated?

There are several different treatments depending on the stage of cancer and your age. These include:

Radiotherapy – where radiation beams are used to kill cancer cells.

Brachytherapy – this is also known as internal radiotherapy as radioactive materials are inserted directly into the tumour or prostate to kill cancerous cells.

High-intensity focused ultrasound (HIFU) – where high frequency sound waves are used to try and kill cancerous cells.

Surgery – this could be keyhole surgery or open surgery and could include removing the prostate.

Hormone therapy – used to stop or slow the production of testosterone to stop or slow prostate cancer.

There is some research to show that radiotherapy is more effective when combined with hormone therapy. Surgical castration is rarely carried out now and only usually after hormone therapy is no longer working.

Side effects can vary from person to person and between treatments. They can include:

Incontinence – this often improves after treatment. Medications and pelvic floor exercises can help

Erectile dysfunction – there are several different treatments for erectile dysfunction which can be effective

Loss of libido

Bladder problems

Tiredness.

What is the prognosis if the prostate cancer has spread?

If your diagnosis comes very late and the cancer has spread – usually to the bones – there is no cure. In this case palliative treatment may be offered to prolong life and ease your symptoms. For more support, read our article about coping with a terminal diagnosis.